CommercialNovember 1, 2024
Access to quality care
At a glance
- In 2025, Anthem updates Blue Priority and Blue Preferred POS plans; Dane county is added, and nine counties are dropped.
- Open enrollment starts November 1, 2024, and ends January 15, 2025, for purchasing insurance on/off Healthcare.gov.
Upcoming changes
In 2025, Anthem is making changes.
Individuals purchasing insurance on and off Healthcare.gov have choices. Open enrollment begins on November 1, 2024, and runs through January 15, 2025.
There are changes for 2025 in our Blue Priority and Blue Preferred POS network plans. These changes are for plans effective January 1, 2025:
- Plans supported by the Blue Priority HMO network will now be available to individuals living in Dane county.
- Plans supported by the Blue Preferred POS network will not be available to individuals living in Dunn, Florence, Fond du Lac, Jefferson, Juneau, Marinette, Portage, Oneida, or Trempealeau counties.
Blue Preferred POS
Blue Preferred POS network is available to individuals living in 63 counties. It will not be available in Dunn, Florence, Fond du Lac, Jefferson, Juneau, Marinette, Portage, Oneida, or Trempealeau counties. This plan offers our broadest network access across the state of Wisconsin. This is a POS product on Blue Preferred POS Network; PCP selection is required for this non-gatekeeper POS plan. Physician-to-physician referrals are not required.
Pathway HMO
Pathway HMO network is available to individuals living in nine counties: Calumet, Kenosha, Milwaukee, Outagamie, Ozaukee, Racine, Washington, Waukesha, and Winnebago. This is an HMO product on Pathway Network; PCP selection is required for this non-gatekeeper plan. Physician-to-physician referrals are not required. Services are limited to urgent/emergent care outside of the Pathway network.
Blue Priority HMO
Blue Priority HMO network to individuals living in eight counties: Brown, Dane, Door, Kewaunee, Manitowoc, Oconto, Rock, and Walworth. Individuals who choose a Blue Priority plan will be able to access providers throughout 44 counties in Wisconsin. This is an HMO product on Blue Priority Network; PCP selection is required for this non-gatekeeper plan. Physician-to-physician referrals are not required. Services are limited to urgent/emergent care outside of the Blue Priority network.
There are no changes to the member identification card prefixes for these plans.
Our Health Insurance Exchange Quick Reference Guide can be found on anthem.com/provider by choosing Forms and Guides.
Through genuine collaboration, we can simplify access to care and help you deliver high-quality, equitable healthcare.
Contact us
Availity Chat with Payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. To access Availity Essentials, go to Availity.com and select the appropriate payer space tile from the drop-down. Then, select Chat with Payer and complete the pre-chat form to start your chat.
Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
WIBCBS-CM-068909-24
PUBLICATIONS: November 2024 Provider Newsletter
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Visit https://providernews.anthem.com/wisconsin/articles/access-to-quality-care-22422
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